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Increase in autism is due to changes in diagnosis, study claims

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7436.364-b (Published 12 February 2004) Cite this as: BMJ 2004;328:364

Rapid Response:

Re: Autism, a politically correct diagnosis?

Autism is not only a politically correct diagnosis. It is also an
escape from the strain on doctor-family relationship arising from
situations where you have a reason to believe that upbringing conditions
play a role in causing emotional disadvantages in children.

Working in a neuropsychiatric assessment team in Sweden I often find
that both parents and referrers prefer to state the problem in
neuropsychiatric terms, even when there is clearly no cause for it. This
also means that referrers fail to highlight adverse circumstances relevant
to the assessment procedure and to the identification of needs in the
families.

Also contributing to this situation is probably the fact that
neuropsychiatric diagnoses pay off well in the benefits and rights schemes
connected to the developmental disorders. I see many children with severe
emotional disturbances in greater need of societal and financial support
than many of the children on the lighter end of neurodevelopmental
disorders, contributions however often go the other way.

Autism diagnoses should to my opinion only be stated by specalists in
Child and Adolescent Psychiatry, since you do need an understanding of the
whole field of adverse influences on children to identify what elements
belong where, and to be able to use the DSM-IV criteria correctly. If you
use them as a "checklist", having insufficient experience of child mental
health problems you risk both suspecting autism where it is not warranted
and also neglecting other mental health needs of children.

Anders Brynge

Consultant CAP

Ryhov Hospital,
Jonkoping,
Sweden

Competing interests:
None declared

Competing interests: No competing interests

17 February 2004
Anders P Brynge
Consultant CAP
Ryhov Hospital, 551 85 Jönköping Sweden